Ashtanga Hridayam Chikitsa sthanam Chapter 16:  Jvara Chikitsitam Adhyaya (Treatment of Fevers)  

The 1st chapter of Cikitsasthanam of Ashtanga Hridayam is named as Jvaracikitsitam Adhyayah. This chapter deals with the explanation of ‘treatment of fevers’.

The topics covered in this chapter include –

–        Langhana in jvara – fasting as a treatment principle in fevers
–        Benefits of Langhana (fasting)
–        Vamana – emesis in fevers
–        Vamana – emesis in fevers
–        Usnambu Pana – drinking of warm water
–        Sadanga Paniya
–        Relationship of pitta, ushma (heat) and jvara (fevers)
–        Avoidance of giving pain killing medicines for severe pain in fevers associated with severe ama
–        Avoidance of giving pain killing medicines for severe pain in fevers associated with severe ama
–        Jvara Chikitsa Krama (order of treatments of fevers)
–        Contraindications of langhana (fasting) in fevers
–        Jvara Chikitsa Krama (order of treatments of fevers)
–        Peyadi Krama (regimen of liquid diet)
–        Administration of Kashaya (herbal decoctions and other formulations) in jvara
–        Use of decoctions of different tastes in fevers casued by different dosha predominance
–        Indications and contraindications of giving medicines in jvara (fevers)
–        Conditions of administering medicines in fever of recent origin
–        Aushadha Yogas – medicinal recipes
–        Aushadha Yogas – medicinal recipes for fevers of vata, pitta and kapha origin
–        Drakshadi Phanta
–        Use of Katuka (Picrorhiza kurroa) in fever and burning sensation
–        Decoctions for fevers of kapha-vata origin
–        Decoction for fever of kapha-pitta origin
–        Decoction for sannipata jvara (fever caused by all three doshas)
–        Use of peya and yusa in fevers
–        Pathya Ahara (suitable foods)
–        Sarpipana – drinking of ghee in fevers
–        Jirna Jvara – chronic fevers
–        Sarpipana – drinking of ghee in fevers
–        Ghrita Shresthata – importance of ghee
–        Decoction for fever associated with cough
–        Pippalyadi Ghrita
–        Tailvaka, Tiktaka and Vrsha Ghrita
–        Vidangadi Ghrita
–        Guduchyadi Ghrita
–        Measures to be done after the digestion of ghee
–        Soup for fevers caused by kapha and pitta
–        Shodana – purificatory therapies
–        Conditions for allowing the expulsion and controlling the expulsion of doshas and malas in jvara
–        Kshirapana – drinking milk in fevers
–        Basti Prayoga – enema therapy in fevers
–        Nasya Prayoga – nasal medication
–        Dhuma – Gandusha Prayogah (inhalation / fumigation and mouth gargles)
–        Treatment of loss of taste in fever
–        Abhyangadi Prayoga – oil massage etc in fevers
–        Lepa Prayoga – anointments in fevers
–        Shitajvara Chikitsa – treatment of fevers with rigors
–        Sannipata Jvara Chikitsa – treatment of fever caused by all three doshas
–        Visama Jvara Chikitsa – treatment of irregular fevers
–        Aparajita Dhupa
–        Siravyadha – venesection
–        Agantu Jvara Cikitsa – treatment of fever due to external agents
–        Apathya – unsuitable things in fever
–        Pathya – suitable things in fever

Pledge by the author(s)

अथातो ज्वरचिकित्सितं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of ‘treatment of fevers’. Thus say (pledge) Atreya and other sages.

Langhana in jvara: Fasting as a treatment principle in fevers

आमाशयस्थो हत्वाग्निं सामो मार्गान् पिधाय यत् ।
विदधाति ज्वरं दोषस्तस्मात्कुर्वीत लङ्घनम् ॥ १ ॥
प्राग्रूपेषु ज्वरादौ वा बलं यत्नेन पालयन् ।
बलाधिष्ठानमारोग्यमारोग्यार्थः क्रियाक्रमः ॥ २ ॥
The Doshas get localized in Amasaya (stomach) destroy the fire (digestive activity), become Sa Ama (mixed with undigested materials) obstruct the passages (of Rasa Dhatu) and produce fever. Therefore Langhana (lightening therapy) should be done. Either during the premonitory stage of Jwara, or commencement of Jwara, afeguarding the strength of the body should be done with all efforts; as the health depends on strength, and the purpose of treatment is maintenance of health.

Benefits of Langhana (Fasting)

लङ्घनैः क्षपिते दोषे दीप्तेऽग्नौ लाघवे सति ।
स्वास्थ्यं क्षुत्तृड्रुचिः पक्तिर्बलमोजश्च जायते ॥ ३ ॥
When the Doshas become reduced by fasting, the digestive power becomes increased, and there is feeling of lightness of the body, health, (comfort), hunger, thirst, desire for food, good digestion, strength and vitality, enthusiasm, immunity manifest.

Indication for Vamana in Jwara:

तत्रोत्कृष्टे समुत्क्लिष्टे कफप्राये चले मले ।
सहृल्लासप्रसेकान्नद्वेषकासविषूचिके ॥ ४ ॥
सद्योभुक्तस्य सञ्जाते ज्वरे सामे विशेषतः ।
वमनं वमनार्हस्य शस्तं When the vitiated Doshas (Malas) are aggravated, have moved out of their seats but not gone out (of the body),when Kapha is predominant and circulating allover the body, it causes symptoms such as nausea, excessive salivation, aversion to food, cough,vomiting and diarrhoea simultaneously,when the fever manifests immediately after meals,especially when the fever is accompanied with Ama, then Vamana therapy is especially ideal to those who are suitable for it.

Adverse effects of Vamana

कुर्यात्तदन्यथा ॥ ५ ॥
श्वासातीसारसम्मोहहृद्रोगविषमज्वरान् ।
If Vamana is administered in contra indicated people, then it causes dyspnoea, diarrhoea, delusion, heart diseases and intermittent fevers.

Vamana herbs

पिप्पलीभिर्युतान् गालान् कलिङ्गैर्मधुकेन वा ॥ ६ ॥
उष्णाम्भसा समधुना पिबेत्सलवणेन वा ।
पटोलनिम्बकर्कोटवेत्रपत्रोदकेन वा ॥ ७ ॥
तर्पणेन रसेनेक्षोर्मद्यैः कल्पोदितानि वा ।
वमनानि प्रयुञ्जीत बलकालविभागवित् ॥ ८ ॥
Gala (Madanaphala – Randia dumetorum) mixed with either Pippali (Piper longum), Kalinga (seeds of Holarrhena antisysenterica) or Madhuka (Glycyrrhiza glabra), should be consumed either with honey or with salt or with hot water. Water boiled with Patola (Trichosanthes dioica), Nimba (Azadirachta indica), Karkota (Momordica dioica), or Vetrapatra (Calamus rotang) can be administered for vamana, or with nutrient materials or sugarcane juice, or by wines; or by other methods described in Kalpasthana (chapter 1, verses 118), thus the emesis therapy should be administered, carefully considering the strength (of the patient and the disease) and time (season, period of the day).

Vamana: Emesis in fevers

कृतेऽकृते वा वमने ज्वरी कुर्याद्विशोषणम् ।
दोषाणां समुदीर्णानां पाचनाय शमाय च ॥ ९ ॥
दोषेण भस्मनेवाग्नौ छन्नेऽन्नं न विपच्यते ।
तस्मादादोषपचनाज्ज्वरितानुपवासयेत् ॥ १० ॥
Whether emesis therapy is administered or not, the patient of fever should undergo fasting, for cooking the increased Doshas and also for mitigating them. Like the fire covered with ash, does not cook the food, similarly the digestive fire covered with the aggravated Doshas; so the patient of fever should be made to fast till the Doshas get fully cooked.

Ushnambu Pana: Drinking of warm water

तृष्णगल्पाल्पमुष्णाम्बु पिबेद्वातकफज्वरे ।
तत्कफं विलयं नीत्वा तृष्णामाशु निवर्तयेत् ॥ ११ ॥
उदीर्य चाग्निं स्रोतांसि मृदूकृत्य विशोधयेत् ।
लीनपित्तानिल स्वेद शकृन्मूत्रानुलोमनम् ॥ १२ ॥
निद्राजाड्यारुचिहरं प्राणानामवलम्बनम् ।
विपरीतमतः शीतं दोषसङ्घातवर्धनम् ॥ १३ ॥
In fevers caused by Vata and Kapha, the patient if thirsty, should drink little quantities of warm water repeatedly; it liquefies the Kapha, relieves thirst quickly, kindles the digestion strength, softens the body channels and cleanses them, initiates the movement in the proper direction and expulsion of, stagnated Pitta, Anila (Vata), sweat, faeces, and urine, dispels sleep, lassitude, and loss of appetite and gives support to life activities. Cold water is opposite in actions) and gives rise to further increase of collection of Doshas and Ama.

Warm water in Pittaja Jwara

उष्णमेवङ्गुणत्वेऽपि युञ्ज्यान्नैकान्तपित्तले ।
उद्रिक्तपित्ते दवथुदाहमोहातिसारिणि ॥ १४ ॥
विषमद्योत्थिते ग्रीष्मे क्षतक्षीणेऽस्रपित्तिनि ।
Though warm water is having these good qualities, it should not be used in fever caused by Pitta alone, not when there is great increase of Pitta (in other kinds of fevers), burning sensation in the eyes and the whole body, delusion and diarrhoea; not in fevers caused by poisons and excess alcohol, not during summer, and in patients suffering from injury to the lungs, emaciation and bleeding disorders.

Shadanga Paniya

घनचन्दन शुण्ठ्यम्बु पर्पटोशीरसाधितम् ॥ १५ ॥
शीतं तेभ्यो हितं तोयं पाचनं तृड्ज्वरापहम् ।
For those persons (patients of fever enumerated above), water boiled with, Cyperus rotundus, Santalum album, Zingiber officinale, Pavonia odorata, Fumaria indica, Vetiveria zizanioides. Such a drink is coolant, comforting, promotes digestion of Ama, relieves thirst and fever.

Relationship of pitta, ushma (heat) and jvara (fever)

ऊष्मा पित्तादृते नास्ति ज्वरो नास्त्यूष्मणा विना ॥ १६ ॥
तस्मात्पित्तविरुद्धानि त्यजेत्पित्ताधिकेऽधिकम् ।
स्नानाभ्यङ्गप्रदेहांश्च परिशेषं च लङ्घनम् ॥ १७ ॥
There is no increase of temperature without the increase of Pitta and there is no fever without increase of temperature; hence in fevers all things (food and activities), which cause increase of Pitta should be avoided, especially so (with greater intent) in fever, where Pitta is greatly increased. Similarly bath; oil massage, anointing the body (with fragrant pastes), and other methods of Langhana (making the body thin and light) should also be avoided.

Avoidance of giving pain relieving medicines for severe pain in fevers associated with severe ama

अजीर्ण इव शूलघ्नं सामे तीव्ररुजि ज्वरे ।
न पिबेदौषधं तद्धि भूय एवाममावहेत् ॥ १८ ॥
आमाभिभूतकोष्ठस्य क्षीरं विषमहेरिव ।
Just as in the disease Ajirna (indigestion) pain relieving herbs should not be administered, even though there is severe pain, similar is the case when is associated with Ama. Because these will further increase the Ama, which is already accumulating in the alimentary tract; just as milk fed to a poisonous serpent (only increases the poison).

Indication for Swedana

सोदर्दपीनसश्वासे जङ्घापर्वास्थिशूलिनि ॥ १९ ॥
वातश्लेष्मात्मके स्वेदः प्रशस्तः स प्रवर्तयेत् ।
स्वेदमूत्रशकृद्वातान् कुर्यादग्नेश्च पाटवम् ॥ २० ॥
In fevers manifesting with Udarda (skin rashes appearing with contact of cold things), in chronic rhinitis, in dyspnoea, pain in the calves, small joints of the fingers and bones; and in fevers caused by Vata and Kapha, sweating therapy is ideal; sweating treatment in these conditions help in the elimination of sweat, urine, faeces and Vata (flatus) and improves the strength of the fire (digestion strength). The patient should adhere to the entire regimen described for oleation therapy fully (vide. verses 26-28 of chapter 16 of Sutrasthana).

Jvara Chikitsa Krama (Order of treatments of fevers)

लङ्घनं स्वेदनं कालो यवाग्वस्तिक्तको रसः ॥ २१ ॥
मलानां पाचनानि स्युर्यथावस्थं क्रमेण वा ।
Fasting, sweating treatment, giving time, drinking of thin gruel, use of bitter tasting herbs Pachana – digestive herbs which cook (transform by heat) the Doshas. These should be administered either as suitable to the stages of fever or in successive order.

Contraindications of langhana (lightening therapies) in fevers

शुद्धवातक्षयागन्तुजीर्णज्वरिषु लङ्घनम् ॥ २२ ॥
नेष्यते तेषु हि हितं शमनं यन्न कर्शनम् ।
Langhana (fasting) is not desirable in fevers caused by Vata alone, in that caused by tissue depletion, fever due to external factors, and in that which has become chronic. For these, Samana (mitigating the Doshas) therapy which does not cause weakness of the body is suitable.

Accessing the effect of Langhana Treatment on Jwara

तत्र सामज्वराकृत्या जानीयादविशोषितम् ॥ २३ ॥        
द्विविधोपक्रमज्ञानमवेक्षेत च लङ्घने ।
By the presence of symptoms of Sama Jvara (vide. Verse no 54/ of chapter 2 of Nidhanasthana), the inadequacy of Langhana therapy should be presumed, and its adequacy should be confirmed by by the presence of symptoms of proper Langhana therapy as described in the Dvividhopakrama chapter (14 of Sutrasthana).

Peyadi Krama (regimen of liquid diet) in Jwara

युक्तं लङ्घितलिङ्गैस्तु तं पेयाभिरुपाचरेत् ॥ २४ ॥
यथास्वौषधसिद्धाभिर्मण्डपूर्वाभिरादितः ।
षडहं वा मृदुत्वं वा ज्वरो यावदवाप्नुयात् ॥ २५ ॥
तस्याग्निर्दीप्यते ताभिः समिद्भिरिव पावकः ।
When the patient is found to have symptoms of proper Langhana therapy, he should be treated with administration of Peya etc. (drinking of gruel), prepared with drugs appropriate to each Dosha, commencing first with Manda, either for six days till the fever become soft (mild). By Peyas, his digestive fire gets increased, just as the fire, by the faggots (small pieces of wood).

Peyadi Krama (Regimen of liquid diet)

प्राग्लाजपेयां सुजरां सशुण्ठीधान्यपिप्पलीम् ॥ २६ ॥
ससैन्धवां तथाऽम्लार्थी तां पिबेत् सहदाडिमाम् ।
सृष्टविड्बहुपित्तो वा सशुण्ठीमाक्षिकां हिमाम् ॥ २७ ॥
वस्तिपार्श्वशिरःशूली व्याघ्रीगोक्षुरसाधिताम् ।
पृश्निपर्णीबलाबिल्वनागरोत्पलधान्यकैः ॥ २८ ॥
सिद्धां ज्वरातिसार्यम्लां पेयां दीपनपाचनीम् ।
ह्रस्वेन पञ्चमूलेन हिक्कारुक्श्वासकासवान् ॥ २९ ॥
First, Laja Peya (thin gruel prepared with fried paddy, processed with Shunti (Zingiber officinale), Coriandrum sattivum, Piper longum with rock salt which is easily digestable, should be consumed. Those desirous of sour taste may take it with Punica granatum. If there is diarrhoea or excess feces formation or great increase of Pitta, cold infusion prepared with Zingiber officinale honey should be administered. If there is pain in the region of the bladder, flanks and head, Peya can be boiled with Vyaghri (Solanum xanthocarpum) and Goksura (Tribulus terrestris). If fever is associated with dysentery / diarrhea, Sour Peya which promotes digestion strength and digests Ama, prepared with Uraria picta, Sida cordifolia, Aegle marmelos, Zingiber officinale, Nymphaea stellata and Coriandrum sativum. For fever associated with hiccup, bodyache and cough, Peya processed with Hrasva Pancamula (roots of Desmodium gangeticum, Uraria picta, Tribulus terrestris, Solanum indicum and Solanum xanthocarpum) drugs is suitable

Peya, Yavagu Recipes

पञ्चमूलेन महता कफार्तो यवसाधिताम् ।
विबद्धवर्चाः सयवां पिप्पल्यामलकैः कृतां ॥ ३० ॥
यवागूं सर्पिषा भृष्टां मलदोषानुलोमनीम् ।
चविकापिप्पलीमूलद्राक्षामलकनागरैः ॥ ३१ ॥
कोष्ठे विबद्धे सरुजि पिबेत्तु परिकर्तिनि ।
कोलवृक्षाम्लकलशीधावनीश्रीफलैः कृताम् ॥ ३२ ॥
अस्वेदनिद्रस्तृष्णार्तः सितामलकनागरैः ।
सिताबदरमृद्वीकाशारिवामुस्तचन्दनैः ॥ ३३ ॥
तृष्णाछर्दिपरीदाहज्वरघ्नीं क्षौद्रसंयुताम् ।
कुर्यात् पेयौषधैरेव रसयूषादिकानपि ॥ ३४ ॥
He, who has predominance of Kapha should consume yavagu processed with Yava (Hordeum vulgare), and 5 roots of Mahat Pancamula (roots fo Aegle marmelos, Clerodendrum phlomidis, Oroxylum indicum, Stereospermum suaveolens and Gmelina arborea). If there is constipation, Yavagu prepared with Yava (Hordeum vulgare), Piper longum, Emblica officinalis, fried in ghee this helps in elimination of feces and the Doshas. If there is painful obstruction in the alimentary tract, Yavagu prepared with Piper retrofractum, Roots of Piper longum, Vitis vinifera, Emblica officinalis and Zingiber officinale. If there is cutting pain in the alimentary tract especially in the rectum, Yavagu prepared with below ingredients should be administered. Ziziphus mauritiana Garcinia indica Uraria picta Aglaia odorata / Solanum virginianum and fruit of Aegle marmelos. He who is suffering from absence of perspiration and sleep and has thirst should take Yavagu mixed with sugar, Emblica officinalis, Zingiber officinale, or processed with sugar, Ziziphus mauritiana Vitis vinifera Hemidesmus indicus Cyperus rotundus, Santalum album and mixed with honey; this cures thirst, vomiting, burning sensation all over the body and fever. Rasa (meat soup) and Yusa (soup of grains) can also be processed with the drugs mentioned for processed Peya and consumed.

Contra indication for Peya

मद्योद्भवे मद्यनित्ये पित्तस्थानगते कफे ।
ग्रीष्मे तयोर्वाधिकयोस्तृट्छर्दिर्दाहपीडिते ॥ ३५ ॥
ऊर्ध्वं प्रवृत्ते रक्ते च पेयां नेच्चन्ति
Peya should not be given to patients with fever caused by drinking wine, who consume alcohol daily, when Kapha has travelled to the seats of Pitta, during summer, when these (Pitta and Kapha) are greatly increased, when the patient is troubled with thirst, vomiting, burning sensation and bleeding from the upper parts of the body (nose, mouth, eyes, ears etc.).

Alternate to peya etc in people with contra indication

तेषु तु ।
ज्वरापहैः फलरसैरद्भिर्वा लाजतर्पणात् ॥ ३६ ॥
पिबेत्सशर्कराक्षौद्रान् ततो जीर्णे तु तर्पणे ।
यवाग्वां वौदनं क्षुद्वानश्नीयाद्भृष्टतण्डुलम् ॥ ३७ ॥
दकलावणिकैर्यूषै रसैर्वा मुद्गलावजैः ।
इत्ययं षडहो नेयो बलं दोषं च रक्षता ॥ ३८ ॥
In the above-mentioned people with contra-indication for Peya and Yavagu, Laja Tarpana (paste of fried paddy) mixed with the juice of fruits which are anti-fever (such as Draksa etc.) or with plain water mixed with sugar and honey, should be given to drink. When this (tarpana – nourishing drink) gets well digested and when he feels hungry, he can be given either Yavagu (gruel) or Odana (cooked rice) prepared by fried rice to be consumed either with Yusa (soup) of Kulattha (horse gram and other pulses) which is watery and salted, or with soup of Vigna radiata or meat of Lava bird. In this manner, the patient should be taken care of for six days, preserving his strength and the Doshas.

Administration of Kashaya (herbal decoctions and other formulations) in jvara

अतः पक्वेषु दोषेषु लङ्घनाद्यैः प्रशस्यते ।
कषायो दोषशेषस्य पाचनः शमनोऽथवा ॥ ३९ ॥
Next, when the Doshas have become cooked (ripe) by Langhana (fasting) etc., administration of Kasaya (decoctions) is suitable, either to cook the remnants (residue) of the Doshas or to mitigate them.

Use of decoctions of different tastes in fevers casued by different dosha predominance

तिक्तः पित्ते विशेषेण प्रयोज्यः कटुकः कफे ।
पित्तश्लेष्महरत्वेऽपि कषायः स न शस्यते ॥ ४० ॥
नवज्वरे मलस्तम्भात्कषायो विषमज्वरम् ।
कुरुतेऽरुचिहृल्लासहिध्माध्मानादिकानपि ॥ ४१ ॥
Medicinal recipes of bitter taste should be used especially for Pitta and of pungent taste for Kapha dominance, Recipes of drugs of astringent taste are not suitable in fevers of recent onset, even though these are mitigators of Pitta and Slesman (Kapha), astringent taste by producing obstruction to expulsion of Malas (Doshas/ feces), gives rise to intermittent fevers, and also causes loss of taste (and appetite), nausea, hiccup, flatulence etc.

Indications and contraindications of giving medicines in jvara (fevers)

सप्ताहादौषधं केचिदाहुरन्ये दशाहतः ।
केचिल्लघ्वन्नभुक्तस्य योज्यमामोल्बणे न तु ॥ ४२ ॥
तीव्रज्वरपरीतस्य दोषवेगोदये यतः ।
दोषेऽथवातिनिचिते तन्द्रास्तैमित्यकारिणि ॥ ४३ ॥
अपच्यमानं भैषज्यं भूयो ज्वलयति ज्वरम् ।
Some authorities say that medicines (antipyretic) should be administered after seven days; others say, after ten days, some others say that it can be given when the patient is taking light foods. It should not be administered when there is increased production of Ama. When the patient is having very high fever, when the movement of Doshas have commenced, when there is great accumulation of Doshas (and also of Ama) producing stupor and inactivity, the medicine, if administered, not undergoing digestion, leads to greater increase of fever.

Conditions of administering medicines in fever of recent origin

मृदुर्ज्वरो लघुर्देहश्चलिताश्च मला यदा ॥ ४४ ॥
अचिरज्वरितस्यापि भेषजं योजयेत्तदा ।
When the fever is mild, there is feeling of lightness of the body, and normal movement of wastes (faeces, urine, flatus), then, medicines can be administered even though the fever is of recent onset.

Aushadha Yogas: Medicinal recipes

मुस्तया पर्पटं युक्तं शुण्ठ्या दुःस्पर्शयापि वा ॥ ४५ ॥
पाक्यं शीतकषायं वा पाठोशीरं सवालकम् ।
पिबेत्तद्वच्च भूनिम्बगुडूचीमुस्तनागरम् ॥ ४६ ॥
यथायोगमिमे योज्याः कषाया दोषपाचनाः ।
ज्वरारोचकतृष्णास्यवैरस्यापक्तिनाशनाः ॥ ४७ ॥
a. Hot infusion or cold infusion prepared from Cyperus rotundus, Fumaria parviflora.

b. or with Zingiber officinale Alhagi camelorum, Cissampelos pareira, Vetiveria zizanioides Pavonia odorata;

c. Andrographis paniculata Tinospora cordifolia, Cyperus rotundus, Zingiber officinale can be consumed.

These kashayas, used appropriately (relevant to the Doshas) bring about ripening of the Doshas and relieve fever, anorexia, thirst, bad taste in the mouth and indigestion.

Aushadha Yogas: Medicinal recipes

कलिङ्गकाः पटोलस्य पत्रं कटुकरोहिणी ॥ ४८अब् ॥
पटोलं शारिवा मुस्ता पाठा कटुकरोहिणी ।
पटोलनिम्बत्रिफलामृद्वीकामुस्तवत्सकाः ॥ ४९ ॥
किराततिक्तममृता चन्दनं विश्वभेषजम् ।
धात्रीमुस्तामृताक्षौद्रमर्धश्लोकसमापनाः ॥ ५० ॥
पञ्चैते सन्ततादीनां पञ्चानां शमना मताः ।
Decoction of drugs of the following five verses bring about the mitigation of the five kinds of fever, commencing with Santata, respectively. Kalingaka (seeds of Holarrhena antidysenterica), patolapatra (leaves of Trichosanthes dioica) and Katukarohini (Picrorhiza kurroa) – for Santata Jvara. Patola (Trichosanthes dioica), Sariva (Hemidesmus indicus), Musta (Cyperus rotundus), Patha (Cissampelos pareira) and Katukarohini (Picrorhiza kurroa) – for Satata Jvara Patola (Trichosanthes dioica), Nimba (Azadirachta indica), Triphala (fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis), Mridvika (Vitis vinifera), Musta (Cyperus rotundus) and Vatsaka (Holarrhena antidysenterica) – for AnyeduskaJvara Kiratatikta (Swertia chirayita), Amrta (Tinospora cordifolia), Chandana (Santalum album) and Vishvabheshaja (Zingiber officinale) – for Tritiyaka Jvara Dhatri (Emblica officinalis), Musta (Cyperus rotundus), Amrita (Tinospora cordifolia) and Kshaudra (honey) – for Chaturthaka Jvara.

Aushadha Yogas: Medicinal recipes for fevers of vata, pitta and kapha origin

दुरालभामृतामुस्तानागरं वातजे ज्वरे ॥ ५१ ॥
अथवा पिप्पलीमूलगुडूचीविश्वभेषजम् ।
कनीयः पञ्चमूलं च पित्ते शक्रयवा घनम् ॥ ५२ ॥
कटुका चेति सक्षौद्रं मुस्तापर्पटकं तथा ।
सधन्वयासभूनिम्बं वत्सकाद्यो गणः कफे ॥ ५३ ॥
अथवा वृषगाङ्गेयीशृङ्गवेरदुरालभाः ।
a. For fever caused by increased Vata, decoctions of Duralabha (Fagonia cretica), Amrta (Tinospora cordifolia), Musta (Cyperus rotundus) and Nagara (Zingiber officinale);

b. or Decoction of Pippalimula (roots of Piper longum), Guduci (Tinospora cordifolia) and Visvabhesaja (Zingiber officinale);

c. or of the drugs of Kaniya (Hrasva) Pancamula (are best suited).

For Jwara caused by Pitta aggravation

d. For Pittajvara, decoction of either of

Shakrayava (Indrayava – seeds of Holarrhena antidysenterica), Ghana (Cyperus rotundus) and Katuka (Picrorhiza kurroa) mixed with Ksaudra (honey);

e. or of Musta (Cyperus rotundus) and Parpataka (Fumaria parviflora);

f. or of Dhanvayasa (Alhagi camelorum) and Bhunimba (Andrographis paniculata) mixed with honey, are best suited.

g. For Jwara caused by Kapha aggravation For Kapha Jvara, decoction of drugs of Vatsakadigana (vide chapter 15 of Sutrasthana); or decoction of Vrisha (Adhatoda vasica),

Gangeyi (Cyperus rotundus), Shringavera (Zingiber officinale) and Duralabha (Fagonia cretica) are best suited.

Aushadha Yogas: Medicinal recipes

रुग्विबन्धानिलश्लेष्मयुक्ते दीपनपाचनम् ॥ ५४ ॥
अभयापिप्पलीमूलशम्याककटुकाघनम् ।
When there is pain (in the body) constipation, predominance of Anila (Vata) and Slesman (Kapha) together, the decoction of Terminalia chebula, Roots of Piper longum, Cassia fistula, Picrorhiza kurroa and Cyperus rotundus, promotes digestion and relieves Ama.

Drakshadi Phanta

द्राक्षामधूकमधुकलोध्रकाश्मर्यशारिवाः ॥ ५५ ॥
मुस्तामलकह्रीवेरपद्मकेसरपद्मकम् ।
मृणालचन्दनोशीरनीलोत्पलपरूषकम् ॥ ५६ ॥
फाण्टो हिमो वा द्राक्षादिर्जातीकुसुमवासितः ।
युक्तो मधुसितालाजैर्जयत्यनिलपित्तजम् ॥ ५७ ॥
ज्वरं मदात्ययं छर्दिं मूर्छां दाहं श्रमं भ्रमम् ।
ऊर्ध्वगं रक्तपित्तं च पिपासां कामलामपि ॥ ५८ ॥
Hot or cold infusion prepared from Vitis vinifera, Glycyrrhiza glabra, Madhuca longifolia, Symplocos racemosa, Gmelina arborea, Hemidesmus indicus, Cyperus rotundus, Emblica officinalis, Pavonia odorata, Nelumbo nucifera, Prunus cerasoides, Nelumbo nucifera, Santalum album, Vetiveria zizanioides, Nymphaea stellata and Grewia asiatica made fragrant with addition of Jatikusuma (flowers of Jasminum sambac) mixed with honey, sugar and fried paddy; this Draksadi Phanta, cures fever due to Anila (Vata) and Pitta alcoholic intoxication, vomiting, fainting, burning sensation, exertion, giddiness, bleeding from upper passages, severe thirst and jaundice.

Use of Katuka (Picrorhiza kurroa) in fever and burning sensation

पाचयेत्कटुकां पिष्ट्वा कर्परेऽभिनवे शुचौ ।
निष्पीडितो घृतयुतस्तद्रसो ज्वरदाहजित् ॥ ५९ ॥
Katuka (Picrorhiza kurroa), made into a paste (with water) is cooked by keeping it on a fresh and clean potsherd; after cooking, the juice extracted from it, mixed with ghee, and consumed cures fever and burning sensation.

Decoctions for fevers of kapha-vata origin

कफवाते वचातिक्तापाठारग्वधवत्सकाः ।
पिप्पलीचूर्णयुक्तो वा क्वाथश्छिन्नोद्भवोद्भवः ॥ ६० ॥
In fevers of Kapha-Vata origin, decoction of Acorus calamus, Swertia chirata, Cissampelos pareira, Cassia fistula and Adhatoda vasica added with powder of Pippali (Piper longum) or decoction of Chinnodbhava (Tinospora cordifolia) (added with Pippali powder) should be consumed.

Decoction for fever of kapha vata origin

व्याघ्रीशुण्ठ्यमृताक्वाथः पिप्पलीचूर्णसंयुतः ।
वातश्लेष्मज्वरश्वासकासपीनसशूलजित् ॥ ६१ ॥
Decoction of Solanum xanthocarpum, Zingiber officinale Tinospora cordifolia added with powder of Pippali (Piper longum) cures fevers of Vata Slesma origin, dyspnoea, cough, Pinasa (rhinitis) and abdominal pain.

Decoction for fever of kapha vata origin

पथ्याकुस्तुम्बुरीमुस्ताशुण्ठीकट्तृणपर्पटम् ।
सकट्फलवचाभार्गीदेवाह्वं मधुहिङ्गुमत् ॥ ६२ ॥
कफवातज्वरष्ठीवकुक्षिहृत्पार्श्ववेदनाः ।
कण्ठामयास्यश्वयथुकासश्वासान् नियच्चति ॥ ६३ ॥
Decoction of Terminalia chebula, Coriandrum sativum, Cyperus rotundus, Zingiber officinale, Cymbopogon citratus, Fumaria parviflora, Myrica esculenta Acorus calamus, Clerodendrum serratum, Cedrus deodara mixed with Madhu (honey) and Ferula narthex cures fever of Kapha – Vata origin, expectoration of sputum, pain in the abdomen, region of the heart and flanks, diseases of the throat, swelling of the face, cough and dyspnoea.

Decoction for fever of kapha pitta origin

आरग्वधादिः सक्षौद्रः कफपित्तज्वरं जयेत् ।
तथा तिक्तावृषोशीरत्रायन्तीत्रिफलामृताः ॥ ६४ ॥
पटोलातिविषानिम्बमूर्वाधन्वयवासकाः ।
Decoction of drugs of Aragvadhadi gana (vide chapter 15 of Sutrasthana) added with honey cures fever of Kaphapitta origin. So also, the decoction of Swertia chirata, Adhatoda vasica, Vetiveria zizanioides, Gentiana kurroo, fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis, Tinospora cordifolia, Trichosanthes dioica, Aconitum heterophyllum, Azadirachta indica, Marsdenia tenacissima Alhagi camelorum.

Decoction for sannipata jvara (Fever caused by all three doshas)

सन्निपातज्वरे व्याघ्रीदेवदारुनिशाघनम् ॥ ६५ ॥
पटोलपत्रनिम्बत्वक्त्रिफलाकटुकायुतम् ।
नागरं पौष्करं मूलं गुडूची कण्टकारिका ॥ ६६ ॥
सकासश्वासपार्श्वार्तौ वातश्लेष्मोत्तरे ज्वरे ।
मधूकपुष्पमृद्वीकात्रायमाणापरूषकम् ॥ ६७ ॥
सोशीरतिक्तात्रिफलाकाश्मर्यं कल्पयेद्धिमम् ।
कषायं तं पिबन् काले ज्वरान्सर्वानपोहति ॥ ६८ ॥
जात्यामलकमुस्तानि तद्वद्धन्वयवासकम् ।
बद्धविट्कटुकाद्राक्षात्रायन्तीत्रिफलागुडम् ॥ ६९ ॥
For Sannipata Jvara – (fever caused by all the Doshas increased simultaneously) Solanum xanthocarpum, Cedrus deodara, Curcuma longa, Cyperus rotundus leaves of Tricosanthes dioica), Nimbatvak – bark of Azadirachta indica fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis along with Picrorhiza kurroa (is ideal). Decoction of Zingiber officinale, Puskaramula (Inula racemosa), Tinospora cordifolia and Solanum xanthocarpum is to be used when there is cough, dyspnoea, pain in the flanks and predominance of Vata and Kapha in Sannipatajvara. Cold infusion prepared from flowers of Madhuca longifolia, Vitis vinifera, Gentiana kurroo, Grewia asiatica, Vetiveria zizanioides, Swertia chirata, fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis and Gmelina arborea consumed at the proper time cures all types of fevers similarly so infusion of Jasminum grandiflorum, Emblica officinalis, Cyperus rotundus Alhagi camelorum. He who has constipation should drink the infusion of Picrorhiza kurroa, Vitis vinifera, Gentiana kurroo, fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis mixed with Guda (molasses).

Use of peya and yusha in fevers

जीर्णौषधोऽन्नं पेयाद्यमाचरेच्च्लेष्मवान्न तु ।
पेया कफं वर्धयति पङ्कं पांसुषु वृष्टिवत् ॥ ७० ॥
श्लेष्माभिष्यण्णदेहानामतः प्रागपि योजयेत् ।
यूषान् कुलत्थचणककलायादिकृतान् लघून् ॥ ७१ ॥
रूक्षांस्तिक्तरसोपेतान् हृद्यान् रुचिकरान् पटून् ।
After the medicine is well digested, the regimen of diet commencing with Peya should be adopted, except by the person who has more Kapha, because Peya increases Kapha just as slush by the rain falling on sand. Hence for persons whose body is heavily moistened by Slesman (Kapha), soup of Dolichos biflorus, Cicer arietinum and Pisum sativum etc., which is easily digestable, dry (not mixed with fatty materials), bitter in taste, pleasing (agreeable) to the mind, tasty, and made saline (by addition if Saindhava salt), should be given at the beginning itself.

Pathya Ahara (suitable foods)

रक्ताद्याः शालयो जीर्णाः षष्टिकाश्च ज्वरे हिताः ॥ ७२ ॥
श्लेष्मोत्तरे वीततुषास्तथा वाटीकृता यवाः ।
ओदनस्तैः स्रुतो द्विस्त्रिः प्रयोक्तव्यो यथायथम् ॥ ७३ ॥
दोषदूष्यादिबलतो ज्वरघ्नक्वाथसाधितः ।
मुद्गाद्यैर्लघुभिर्यूषाः कुलत्थैश्च ज्वरापहाः ॥ ७४ ॥
In fever, old rice such as Raktasali (red rice – Oryza sativa) etc., and Sastika rice are suitable as food. In case of predominance of Kapha, Hordeum vulgare removed of its husk, fried and made into small pieces is ideal. Rice mess prepared from rice, washed twice or thrice in water, and boiled in the decoction of drugs which are antifebrile, should be administered, considering carefully the strength of the Doshas, Dusyas, etc., (place, time, season, age, congeniality etc.). Yusha (soup) of Vigna radiata etc. which are light, and of Dolichos biflorus cure fever.

Pathya Ahara (suitable foods)

कारवेल्लककर्कोटबालमूलकपर्पटैः ।
वार्ताकनिम्बकुसुमपटोलफलपल्लवैः ॥ ७५ ॥
अत्यन्तलघुभिर्मांसैर्जाङ्गलैश्च हिता रसाः ।
व्याघ्रीपरूषतर्कारीद्राक्षामलकदाडिमैः ॥ ७६ ॥
संस्कृताः पिप्पलीशुण्ठीधान्यजीरकसैन्धवैः ।
सितामधुभ्यां प्रायेण संयुता वा कृताकृताः ॥ ७७ ॥
Meat soup prepared from easily digestable meat of animals of desert like region, processed with Karavellaka (Momordica charantia), Momordica dioica, tender Raphanus sativus, Fumaria officinalis, Solanum indicum, flowers of Nimba (Azadirachta indica), fruits and tender leaves of Trichosanthes dioica is best suited; or it (meat soup) may be processed with Solanum xanthocarpum, Grewia asiatica, Clerodendrum phlomidis, Vitis vinifera, Emblica officinalis and Dadima (Punica granatum); or with Piper longum, Zingiber officinale, Coriandrum sativum, Cuminum cyminum and rock salt each one may be added with sugar and honey; or it (meat soup) may be used processed (with addition of spices and salt) or unprocessed.

Pathya Ahara (suitable foods)

अनम्लतक्रसिद्धानि रुच्यानि व्यञ्जनानि च ।
अच्चान्यनलसम्पन्नान्यनुपानेऽपि योजयेत् ॥ ७८ ॥
तानि क्वथितशीतं च वारि मद्यं च सात्म्यतः ।
सज्वरं ज्वरमुक्तं वा दिनान्ते भोजयेल्लघु ॥ ७९ ॥
श्लेष्मक्षयविवृद्धोष्मा बलवान् अनलस्तदा ।
यथोचितेऽथवा काले देशसात्म्यानुरोधतः ॥ ८० ॥
प्रागल्पवह्निर्भुञ्जानो न ह्यजीर्णेन पीड्यते ।
Vyanjana (lickable menu prepared from vegetables) processed with non-sour buttermilk, tasty in nature, thin in consistency and clear, and cooked on fire, may be partaken (along with the main food). Even for, Anupana (afterdrink), water boiled and cooled or wine, which ever is accustomed may be prescribed. The patient who is having fever or who has been cured of fever, should be asked to take light food at the end of the day, for at that time Slesman (Kapha) undergoes decrease and the heat of the body increases. Then the digestive fire will be powerful (to digest the food); or the food may be taken at such a time as is appropriate to the habitat and accustomisation. He, who eats earlier (to the end of the day) when the digestive fire is weak, will he not suffer from indigestion? (certainly he will).

Sarpipana: Drinking of ghee in fevers

कषायपानपथ्यान्नैर्दशाह इति लङ्घिते ॥ ८१ ॥
सर्पिर्दद्यात्कफे मन्दे वातपित्तोत्तरे ज्वरे ।
पक्वेषु दोषेष्वमृतं तद्विषोपममन्यथा ॥ ८२ ॥
दशाहे स्यादतीतेऽपि ज्वरोपद्रववृद्धिकृत् ।
लङ्घनादिक्रमं तत्र कुर्यादाकफसङ्क्षयात् ॥ ८३ ॥
When the body is made light, by the use of Kasaya (medicinal recipes) and diet for ten days, ghee (medicated) may be administered for fever which has less Kapha and more Vata and Pitta; ghee is like ambrosia when the Doshas are Pakva (well processed by heat and not having Ama) but is poison when otherwise (Doshas are Apakva and having Ama). Even after the lapse of ten days, it (drinking ghee)will cause increase of Upadravas (complications, secondary diseases) of fever, if there is Kapha dominance, then Langhana (fasting) and other methods (of making the body thin) should be adopted till the Kapha undergoes decrease completely.

Jirna Jvara: Chronic fevers

देहधात्वबलत्वाच्च ज्वरो जीर्णोऽनुवर्तते ।
Due to the poor strength of the body and tissues, the fever becomes chronic and persists long.

Sarpipana: Drinking of ghee in fevers

रूक्षं हि तेजो ज्वरकृत्तेजसा रूक्षितस्य च ॥ ८४ ॥
वमनस्वेदकालाम्बुकषायलघुभोजनैः ।
यः स्यादतिबलो धातुः सहचारी सदागतिः ॥ ८५ ॥
तस्य संशमनं सर्पिर्दीप्तस्येवाम्बु वेश्मनः ।
Dry heat only, is the producer of fever. In the person who has been made dry by the heat of fever, Sadagati (Vata) which is associated with it, is very powerful (in function), because of the effect of emesis; sudation, lapse of time, drinking of warm water, medicines and light food, Vata mitigation is possible by drinking of ghee, just as the fire of a burning house can be extinguished by water poured on it.

Ghrita Shresthata: Importance of ghee

वातपित्तजितामग्र्यं संस्कारं चानुरुध्यते ॥ ८६ ॥
सुतरां तद्ध्यतो दद्याद्यथास्वौषधसाधितम् ।
विपरीतं ज्वरोष्माणं जयेत्पित्तं च शैत्यतः ॥ ८७ ॥
स्नेहाद्वातं घृतं तुल्यं योगसंस्कारतः कफम् ।
पूर्वे कषायाः सघृताः सर्वे योज्या यथामलम् ॥ ८८ ॥
Ghee is foremost among those which overcome Vata and Pitta, it retains its qualities and incorporates the qualities of the ingredients with which it is processed, hence, it should always be administered after processing with herbs related to the Doshas (to mitigate their increase). Ghee is antagonistic to the heat of fever, overcomes Pitta by its coldness, ghee wins over Vata by its unctuousness and Kapha by processing it with appropriate anti Kapha herbs. All the Kasayas described earlier, should be administered mixed with ghee, as per the aggravated Doshas.

Decoction for fever associated with cough

त्रिफलापिचुमन्दत्वङ्मधुकं बृहतीद्वयम् ।
समसूरदलं क्वाथः सघृतो ज्वरकासहा ॥ ८९ ॥
Decoction of fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis bark of Azadirachta indica Glycyrrhiza glabra the two Brhati (Solanum indicum and Solanum xanthocarpum) along with Lens culinaris mixed with ghee cures fever and cough.

Pippalyadi Ghrita

पिप्पलीन्द्रयवधावनितिक्तासारिवामलकतामलकीभिः ।
बिल्वमुस्तहिमपालनिसेव्यैर्द्राक्षयातिविषया स्थिरया च ॥ ९० ॥
घृतमाशु निहन्ति साधितं ज्वरमग्निं विषमं हलीमकम् ।
अरुचिं भृशतापमंसयोर्वमथुं पार्श्वशिरोरुजं क्षयम् ॥ ९१ ॥
Medicated ghee prepared with Piper longum, seeds of Holarrhena antidysenterica, Solanum xanthocarpum, Swertia chirata, Hemidesmus indicus, Emblica officinalis, Phyllanthus niruri, Aegle marmelos, Cyperus rotundus, Santalum album, Gentiana kurroo, Vetiveria zizanioides, Vitis vinifera, Aconitum heterophyllum, Desmodium gangeticum quickly cures fevers, irregularities of digestion, advanced stage of jaundice loss of taste and appetite, severe burning sensation in the shoulders, vomiting, pain in the flanks and headache and consumption (tuberculosis).

Tailvaka, Tiktaka and Vrisha Ghrita

तैल्वकं पवनजन्मनि ज्वरे योजयेत्त्रिवृतया वियोजितम् ।
तिक्तकं वृषघृतं च पैत्तिके यच्च पालनिकया शृतं हविः ॥ ९२ ॥
Tailvaka Ghrita (vide – chapter 21/32) devoid of Operculina turpethum should be administered in fever born of Pavana (Vata), Tiktaka Ghrita (vide chapter 19/2), Vrsa Ghrita (chapter 2/40) and that processed with Gentiana kurroo is suitable for fevers arising from Pitta.

Vidangadi Ghrita

विडङ्गसौवर्चलचव्यपाठाव्योषाग्निसिन्धूद्भवयावशूकैः ।
पलांशकैः क्षीरसमं घृतस्य प्रस्थं पचेज्जीर्णकफज्वरघ्नम् ॥ ९३ ॥
One Pala each of below herbs are taken:
Embelia ribes, Black salt, Piper retrofractum, Cissampelos pareira, Piper longum, Piper nigrum and Zingiber officinale, Plumbago zeylanica, rock salt, Hordeum vulgare processed with equal quantities of milk and ghee each one Prastha is useful in chronic fever arising from Kapha.

Guduchyadi Ghrita

गुडूच्या रसकल्काभ्यां त्रिफलाया वृषस्य वा ।
मृद्वीकाया बलायाश्च स्नेहाः सिद्धा ज्वरच्चिदः ॥ ९४ ॥
Ghee prepared with fresh juice and paste of Guduchi (Tinospora cordifolia), (juice and paste of) Triphala (fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis), or with juice and paste of Adhatoda vasica or with Vitis vinifera or with Sida cordifolia (thus five recipes separately) cure fevers

Measures to be taken after the digestion of ghee

जीर्णे घृते च भुञ्जीत मृदुमांसरसौदनम् ।
बलं ह्यलं दोषहरं परं तच्च बलप्रदम् ॥ ९५ ॥
After the medicated ghee is well digested, the patient should eat Odana (boiled rice) along with soup of soft meat. Strength (of the tissues/body) itself is enough to overcome the Doshas and this (rice mess and meat soup), is the best for giving strength.

Soup for fevers caused by kapha and pitta

कफपित्तहरा मुद्गकारवेल्लादिजा रसाः ।
प्रायेण तस्मान्न हिता जीर्णे वातोत्तरे ज्वरे ॥ ९६ ॥
शूलोदावर्तविष्टम्भजनना ज्वरवर्धनाः ।
Soup of Mudga (Vigna radiata), Momordica charantia etc. overcome Kapha and Pitta, hence probably they are not suitable in chronic fevers having predominance of Vata; these produce pain in the abdomen, upward movement of Vata, constipation and increase of fever.

Shodhana: Purificatory therapies

न शाम्यत्येवमपि चेज्ज्वरः कुर्वीत शोधनम् ॥ ९७ ॥
शोधनार्हस्य वमनं प्रागुक्तं तस्य योजयेत् ।
आमाशयगते दोषे बलिनः पालयन् बलम् ॥ ९८ ॥
If even with all these therapies the fever does not subside, then Sodhana (purifactory therapies) should be administered to those who are suitable to them. Vamana (emesis) should be administered as described earlier when the Doshas are localised in the Amasaya (stomach) for the patient who is strong, and after safeguarding his strength.

Shodana: Purificatory therapies

पक्वे तु शिथिले दोषे ज्वरे वा विषमद्यजे ।
मोदकं त्रिफलाश्यामात्रिवृत्पिप्पलिकेसरैः ॥ ९९ ॥
ससितामधुभिर्दद्याद्व्योषाद्यं वा विरेचनम् ।
द्राक्षाधात्रीरसं तद्वत्सद्राक्षां वा हरीतकीम् ॥ १०० ॥
लिह्याद्वा त्रैवृतं चूर्णं संयुक्तं मधुसर्पिषा |
आरग्वधं वा पयसा मृद्वीकानां रसेन वा ।
त्रिफलां त्रायमाणां वा पयसा ज्वरितः पिबेत् ॥ १०१ ॥
विरिक्तानां च संसर्गी मण्डपूर्वा यथाक्रमम् ।
In fevers in which the Doshas are ripe and loose (not adhering to the tissues and channels) or in fevers caused by poison or alcohol, Pills prepared with fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis, Operculina turpethum, Piper longum, Mesua ferrea added with Sita (sugar) and Madhu (honey) may be administered to produce purgation; or Vyosadi Ghrita (vide chapter 2/21 of Kalpasthana); or powder of Trivrt (Operculina turpethum) may be licked with honey and ghee; similarly Draksa (Vitis vinifera) and juice of Dhatri (Emblica officinalis) or with Draksa (Vitis vinifera), Haritaki (Terminalia chebula) or Aragvadha (Cassia fistula) (each separately) may be consumed with milk or juice of Mrdvika (Vitis vinifera); or either Triphala (fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis) or Trayamana (Gentiana kurroo) along with milk may be consumed by the patient of fever. After purgation (and emesis therapies) Samsarga (regimen of liquid diet) should be adopted commencing with Manda (thin gruel).

च्यवमानं ज्वरोत्क्लिष्टमुपेक्षेत मलं सदा ॥ १०२ ॥
पक्वोऽपि हि विकुर्वीत दोषः कोष्ठे कृतास्पदः ।
अतिप्रवर्तमानं वा पाचयन् सङ्ग्रहं नयेत् ॥ १०३ ॥
आमसङ्ग्रहणे दोषा दोषोपक्रमीरिताः ।
पाययेद्दोषहरणं मोहादामज्वरे तु यः ॥ १०४ ॥
प्रसुप्तं कृष्णसर्पं स कराग्रेण परामृशेत् ।
If by the effect of fevers, the wastes (feaces, urine etc.) are going out of the body always (frequently)they should be neglected (not stopped by medicines or diet) even though they are well cooked if stopped, they remaining inside the alimentary tract, give rise to complications. If there is too much of elimination, it may be controlled by administering Pachana (digestive medicine); the harmful effects of the Doshas which are in Ama (unripe) state have already been described in the Dosha Upakrama (chapter 13 of Sutrasthana); (so it should not be stopped). He (the physician) who by lack of knowledge administers purifactory treatment in Amajvara (fever in which there is accumulation of undigested materials in the alimentary tract and Rasa Dhatu) or fever of recent onset, will only be touching (waking) a sleeping black cobra with his fingers.

Kshirapana: Drinking milk in fevers

ज्वरक्षीणस्य न हितं वमनं न विरेचनम् ॥ १०५ ॥
कामं तु पयसा तस्य निरूहैर्वा हरेन्मलान् ।
क्षीरोचितस्य प्रक्षीणश्लेष्मणो दाहतृड्वतः ॥ १०६ ॥
क्षीरं पित्तानिलार्तस्य पथ्यमप्यतिसारिणः ।
तद्वपुर्लङ्घनोत्तप्तं प्लुष्टं वनमिवाग्निना ॥ १०७ ॥
दिव्याम्बु जीवयेत्तस्य ज्वरं चाशु नियच्चति ।
संस्कृतं शीतमुष्णं वा तस्माद्धारोष्णमेव वा ॥ १०८ ॥
विभज्य काले युञ्जीत ज्वरिणं हन्त्यतोऽन्यथा ।
For the patient who is debilitated by fever, neither emesi nor purgation therapy is suitable; the waste products may be expelled out, if necessary, by either milk (drinking) or by a Niruha (decoction enema). For the person who is accustomed to milk, in whom there is great decrease of Kapha, who is suffering from burning sensation and thirst, who is troubled by increase of Pitta and Vata, the milk is suitable, even for a patient with diarrhoea. It invigorates the body which is weakened by Langhana (fasting and other thinning therapies) just as rain water helps growth of the forest which has been destroyed by fire. It cures fever soon. Hence milk processed (boiled with appropriate drugs), consumed cold or warm, or fresh warm milk direct from the cows udder should be administered to a patient of fever carefully considering the time (season, time of the day and night, stage of fever etc.), otherwise (administered in any other manner) it will kill the fever patient.

Kshirapana: Drinking milk in fevers

पयः सशुण्ठीखर्जूरमृद्वीकाशर्कराघृतम् ॥ १०९ ॥
शृतशीतं मधुयुतं तृड्दाहज्वरनाशनम् ।
तद्वद्द्राक्षाबलायष्टीसारिवाकणचन्दनैः ॥ ११० ॥
चतुर्गुणेनाम्भसा वा पिप्पल्या वा शृतं पिबेत् ।
Milk boiled with Zingiber officinale, Phoenix dactylifera, Vitis vinifera, sugar and ghee, heated then cooled and consumed mixed with honey will relieve thirst, burning sensation and fever. Similarly milk boiled with Vitis vinifera, Sida cordifolia, Glycyrrhiza glabra, Hemidesmus indicus, Piper longum and Santalum album acts likewise. Milk may be boiled with water four times its quantity (and reduced to a quarter) or may be boiled with Piper longum and consumed.

Kshirapana: Drinking milk in fevers

कासाच्छ्वासाच्चिरःशूलात्पार्श्वशूलाच्चिरज्वरात् ॥ १११ ॥
मुच्यते ज्वरितः पीत्वा पञ्चमूलीशृतं पयः ।
शृतमेरण्डमूलेन बालबिल्वेन वा ज्वरात् ॥ ११२ ॥
धारोष्णं वा पयः पीत्वा विबद्धानिलवर्चसः ।
सरक्तपिच्छातिसृतेः सतृट्शूलप्रवाहिकात् ॥ ११३ ॥
The patient of fever gets relieved of cough, dyspnoea, headache, pain in the flanks and chronic fever by drinking milk boiled with five roots of Brihat Panchamula; by drinking milk boiled either with roots of Eranda (Ricinus communis) or tender fruits of Bilva (Aegle marmelos) gets free from fever. By drinking warm milk direct from the cow’s udder, the patient of fever gets relieved of obstruction of flatus and faeces, diarrhoea with more of blood and mucus, thirst, pain in the abdomen and straining at stools.

Kshirapana: Drinking milk in fevers

सिद्धं शुण्ठीबलाव्याघ्रीगोकण्टकगुडैः पयः ।
शोफमूत्रशकृद्वातविबन्धज्वरकासजित् ॥ ११४ ॥
वृश्चीवबिल्ववर्षाभूसाधितं ज्वरशोफनुत् ।
शिंशिपासारसिद्धं च क्षीरमाशु ज्वरापहम् ॥ ११५ ॥
Milk processed with Zingiber officinale, Sida cordifolia, Solanum xanthocarpum, Tribulus terrestris added with jaggery relieves oedema, obstruction of urine, faeces and flatus, fever and cough; boiled with Boerhavia diffusa, Aegle marmelos, Boerhavia diffusa. It relieves fever and oedema; milk processed with the extract of Simsipa (Dalbergia sissoo) cures fever quickly.

Basti Prayoga: Enema therapy in fevers

निरूहस्तु बलं वह्निं विज्वरत्वं मुदं रुचिम् ।
दोषे युक्तः करोत्याशु पक्वे पक्वाशयं गते ॥ ११६ ॥
पित्तं वा कफपित्तं वा पक्वाशयगतं हरेत् ।
स्रंसनं त्रीनपि मलान्बस्ति: पक्वाशयाश्रयान् ॥ ११७ ॥
Niruha (decoction enema) bestows strength, improves digestion strength, relieves fever, gives comfort and improves taste in food, if administered appropriately, when the Doshas are ripe and localised in the Pakvasaya (large intestines). Sramsana (mild purgative therapy) removes Pitta or Kapha and Pitta localised in the Pakvasaya, whereas Basti (enema therapy) removes all the three Doshas localised in the Pakvashaya.

Basti Prayoga: Enema therapy in fevers

प्रक्षीणकफपित्तस्य त्रिकपृष्ठकटीग्रहे ।
दीप्ताग्नेर्बद्धशकृतः प्रयुञ्जीतानुवासनम् ॥ ११८ ॥
Anuvasana (oil enema) should be administered to a patient of fever who has severe depletion of Kapha and Pitta, has catching pain in the upper portion of the back and waist, who has increased digestive activity and constipation.

Basti Prayoga: Enema therapy in fevers

पटोलनिम्बच्चदनकटुकाचतुरङ्गुलैः ।
स्थिराबलागोक्षुरकमदनोशीरवालकैः ॥ ११९ ॥
पयस्यर्धोदके क्वाथं क्षीरशेषं विमिश्रितम् ।
कल्कितैर्मुस्तमदनकृष्णामधुकवत्सकैः ॥ १२० ॥
बस्तिं मधुघृताभ्यां च पीडयेज्ज्वरनाशनम् ।
Leaves of Patola (Trichosanthes dioica), bark of Nimba (Azadirachta indica), Picrorhiza kurroa, Cassia fistula, Desmodium gangeticum, Sida cordifolia, Tribulus terrestris, Randia dumetorum, Vetiveria zizanioides and Pavonia odorata are made into decoction and mixed with twice the quantity of milk, a paste of Cyperus rotundus, Randia dumetorum, Piper longum, Glycyrrhiza glabra and Holarrhena antidysenterica honey and ghee are all mixed together and administered as enema, cures fever.

Basti Prayoga: Enema therapy in fevers

चतस्रः पर्णिनीर्यष्टीफलोशीरनृपद्रुमान् ॥ १२१ ॥
क्वाथयेत् कल्कयेद्यष्टीशताह्वाफलिनीफलम् ।
मुस्तं च बस्ति: सगुडक्षौद्रसर्पिर्ज्वरापहः ॥ १२२ ॥
The four Parnis – Vigna trilobata, Teramnus labialis, Desmodium gangeticum, Uraria picta, Glycyrrhiza glabra, Randia dumetorum, Vetiveria zizanioides, Cassia fistula are made into a decoction, a paste of Glycyrrhiza glabra, Anethum graveolens, Callicarpa macrophylla, Randia dumetorum and Cyperus rotundus is mixed with the decoction, is administered as enema along with Guda (molasses), honey and ghee this cures fever.

Basti Prayoga: Enema therapy in fevers

जीवन्तीं मदनं मेदां पिप्पलीं मधुकं वचाम् ।
ऋद्धिं रास्नां बलां बिल्वं शतपुष्पां शतावरीम् ॥ १२३ ॥
पिष्ट्वा क्षीरं जलं सर्पिस्तैलं चैकत्र साधितम् ।
ज्वरेऽनुवासनं दद्याद्यथास्नेहं यथामलम् ॥ १२४ ॥
Leptadenia reticulata, Randia dumetorum, Polygonatum verticillatum, Piper longum, Glycyrrhiza glabra, Acorus calamus, Habenaria intermedia, Pluchea lanceolata, Sida cordifolia, Aegle marmelos, Anethum sowa and Asparagus racemosus the above herbs are made into paste and mixed with milk, water, ghee and (sesame) oil and administered as oil enema. The fat for this enema is selected as per the aggravated Dosha.

Basti Prayoga: Enema therapy in fevers

ये च सिद्धिषु वक्ष्यन्ते बस्तयो ज्वरनाशनाः ।
Even the enema recipes which will be described in the Siddhisthana (chapter 4 of Kalpasiddhisthana) also cure fevers.

Nasya Prayoga: Nasal medication

शिरोरुग्गौरवश्लेष्महरमिन्द्रियबोधनम् ॥ १२५ ॥
जीर्णज्वरे रुचिकरं दद्यान्नस्यं विरेचनम् ।
स्नैहिकं शून्यशिरसो दाहार्ते पित्तनाशनम् ॥ १२६ ॥
In chronic fevers Virechana Nasya (purifictory nasal medication) should be administered, this will relieve headache and feeling of heaviness of the head, mitigates Kapha and improves strength of sense organs and enhances taste. The person who has feeling of emptiness of the head and burning sensation, should be administered Sneha Nasya (oil or lubricating nasal medication) which mitigates Pitta.

Dhuma Gandusha Prayogah (inhalation / fumigation and mouth gargles)

धूमगण्डूषकवलान्यथादोषं च कल्पयेत् ।
प्रतिश्यायास्यवैरस्यशिरःकण्ठामयापहान् ॥ १२७ ॥
Inhalation of smoke, holding liquids in the mouth and mouth gargles, appropriate to the Dosha may also be administered, these therapies relieve running nose, bad taste in the mouth, headache, throat disorders.

Treatment of loss of taste in fever

अरुचौ मातुलुङ्गस्य केसरं साज्यसैन्धवम् ।
धात्रीद्राक्षासितानां वा कल्कमास्येन धारयेत् ॥ १२८ ॥
When there is loss of taste, a paste of Citrus medica, Mesua ferrea mixed with ghee and rock salt, or paste of Emblica officinalis, Vitis vinifera mixed with sugar should be held in the mouth for some time.

Abhyangadi Prayoga: Oil massage etc in fevers

यथोपशयसंस्पर्शान् शीतोष्णद्रव्यकल्पितान् ।
अभ्यङ्गालेपसेकादीञ्ज्वरे जीर्णे त्वगाश्रिते ॥ १२९ ॥
कुर्यादञ्जनधूमांश्च तथैवागन्तुजेऽपि तान् ।
Oil bath, application of medicinal paste, sprinkling, bathing, fomentation etc. should be done in chronic fevers localised in the skin; so also Anjana (application of medicinal collyrium into the eyes) and Dhuma (inhalation of smoke of herbs) should be done for Agantujvara (fevers caused by external causes). They should be planned and executed according to comfort of touch using medicines prepared with herbs of cold and hot potencies.

Abhyangadi Prayoga: Oil massage etc in fevers

दाहे सहस्रधौतेन सर्पिषाभ्यङ्गमाचरेत् ॥ १३० ॥
When there is burning sensation, massage should be done with Sahasra Dhauta ghrita – 100 times water washed ghee.

Abhyangadi Prayoga: Oil massage etc in fevers

सूत्रोक्तैश्च गणैस्तैस्तैर्मधुराम्लकषायकैः ।
दूर्वादिभिर्वा पित्तघ्नैः शोधनादिगणोदितैः ॥ १३१ ॥
शीतवीर्यैर्हिमस्पर्शैः क्वाथकल्कीकृतैः पचेत् ।
तैलं सक्षीरमभ्यङ्गात्सद्यो दाहज्वरोपहम् ॥ १३२ ॥
शिरो गात्रं च तैरेव नातिपिष्टैः प्रलेपयेत् ।
तत्क्वाथेन परीषेकमवगाहं च योजयेत् ॥ १३३ ॥
तथारनालसलिलक्षीरशुक्तघृतादिभिः ।

Herbs of sweet, sour and astringent groups explained vide chapter 10 of Sutrasthana or Durvadigana etc described in SodhanadiGana Adhyaya (chapter 15 of Sutrasthana) which mitigate Pitta, which are cold in potency and cold in to touch, made into decoction and pastes are cooked along with milk and oil to prepare massage oil. Anointing the body with this oil mixed with milk, quickly cures burning sensation and fever. Both the head and body should be smeared with this oil; without excessive paste, this decoction be poured / sprinkled over the body or the patient given a tub bath with it. Grain fermented liquid, water, milk, fermented gruel and/or ghee may also be used similarly.

Lepa Prayoga: Anointments in fevers

कपित्थमातुलुङ्गाम्लविदारीलोध्रदाडिमैः ॥ १३४ ॥
बदरीपल्लवोत्थेन फेनेनारिष्टकस्य वा ।
लिप्तेऽङ्गे दाहरुङ्मोहाश्छर्दिस्तृष्णा च शाम्यति ॥ १३५ ॥
यो वर्णितः पित्तहरो दोषोपक्रमणे क्रमः ।
तं च शीलयतः शीघ्रं सदाहो नश्यति ज्वरः ॥ १३६ ॥
Frothy paste prepared from the tender leaves of either Feronia linonia, Citrus medica, Emblica officinalis, Pueraria tuberosa, Symplocos racemosa, Punica granatum, Ziziphus mauritiana or Azadirachta indica smeared over the body relieves burning sensation, pain, delusion, vomiting and thirst. He who adopts the methods which mitigate Pitta described in Dosopakrama Adhyaya (chapter 13 of Sutrasthana) gets relieved of fever accompanied with burning sensation quickly.

Shitajvara Chikitsa: Treatment of fevers with rigors

वीर्योष्णैरुष्णसंस्पर्शैस्तगरागुरुकुङ्कुमैः ।
कुष्ठस्थौणेयशैलेयसरलामरदारुभिः ॥ १३७ ॥
नखरास्नापुरवचाचण्डैलाद्वयचोरकैः ।
पृथ्वीकाशिग्रुसुरसाहिंस्राध्यामकसर्षपैः ॥ १३८ ॥
दशमूलामृतैरण्डद्वयपत्तूररोहिषैः ।
तमालपत्रभूतीकशल्लकीधान्यदीप्यकैः ॥ १३९ ॥
मिशिमाषकुलत्थाग्निप्रकीर्यानाकुलीद्वयैः ।
अन्यैश्च तद्विधैर्द्रव्यैः शीते तैलं ज्वरे पचेत् ॥ १४० ॥
क्वथितैः कल्कितैर्युक्तैः सुरासौवीरकादिभिः ।
तेनाभ्यञ्ज्यात्सुखोष्णेन तैः सुपिष्टैश्च लेपयेत् ॥ १४१ ॥
कवोष्णैस्तैः परीषेकमवगाहं च कल्पयेत् ।
केवलैरपि तद्वच्च शुक्तगोमूत्रमस्तुभिः ॥ १४२ ॥
आरग्वधादिवर्गं च पानाभ्यञ्जनलेपने ।
धूपानगुरुजान्यांश्च वक्ष्यन्ते विषमज्वरे ॥ १४३ ॥
अग्न्यनग्निकृतान् स्वेदान् स्वेदि भेषजभोजनन् ।
गर्भभूवेश्मशयनं कुथकम्बलरल्लकान् ॥ १४४ ॥
निर्धूमदीप्तैरङ्गारैर्हसन्तीश्च हसन्तिकाः ।
मद्यं सत्र्यूषणं तक्रं कुलत्थव्रीहिकोद्रवान् ॥ १४५ ॥
संशीलयेद्वेपथुमान्यच्चान्यदपि पित्तलम् ।
दयिताः स्तनशालिन्यः पीना विभ्रमभूषणाः ॥ १४६ ॥
यौवनासवमत्ताश्च तमालिङ्गेयुरङ्गनाः ।
वीतशीतं च विज्ञाय तास्ततोऽपनयेत्पुनः ॥ १४७ ॥
Herbs which are hot in potency and on touch such as Tagara (Valeriana wallichii), Aquilaria agallocha Crocus sativus, Saussurea lappa, Taxus baccata, Parmelia perlata, Pinus roxburghii, Cedrus deodara, Martynia annua, Pluchea lanceolata, Commiphora mukul, Acorus calamus, Rhus parviflora, Elettaria cardamomum and Amomum subulatam, Angelica glauca, Ferula narthex, Moringa oleifera, Ocimum sanctum, Capparis spinosa, Cymbopogon martini, Brassica nigra, 10 roots, Tinospora cordifolia two varieties of Ricinus communis, Caesalpinia sappan, Cymbopogon martini, Cinnamomum tamala, Cymbopogon citratus, Boswellia serrata, Coriandrum sativum, Trachyspermum ammi, Foeniculum vulgare, Vigna mungo, Dolichos biflorus, Plumbago zeylanica Holoptelea integrifolia / Pongamia pinnata, Rauvolfia serpentina / Aristolochia indica and using other herbs similar in nature, oil is cooked. Making decoction and herbal paste of above herbs, added with fermented liquors. This oil should be massaged on the body comfortably warm, a nice paste of the above drugs applied warm over the body. In case of fever caused along with cold, rigors, above warm decoction, oil etc should be used for pouring on the body and tub bath. Similarly, fermented gruel, cow urine or whey, may be used alone (without processing with herbs). Herbs of Aragvadhadi Varga (vide chapter 15 of Sutrasthana) may be made use for drinking water, oil massage and skin application; fumigation with Aquilaria agallocha and others prescribed for recurrent fever, sudation (diaphoresis therapy) with or without the use of fire, for persons who are suitable for this therapy; use of medicines and foods which produce sweating such as remaining inside apartments surrounded by thick walls or which are under the ground, sleeping by covering the body with blanket and other thick sheets, sitting near a hearth or oven with burning coal, and devoid of smoke; use of wine, buttermilk added with Piper longum, Piper nigrum and Zingiber officinale, Dolichos biflorus, Oryza sativa, Paspalum Scrobiculatum these and any others which increase Pitta should be adopted by the patient of fever having shivering (rigor). Flirtatious beloved women who have elevated breasts, decorated with jewels, intoxicated with the spirit of youth should embrace him and then the women should withdraw after knowing that he is free from cold (rigors).

Sannipata Jvara Chikitsa: Treatment of fever caused by all three doshas

वर्धनेनैकदोषस्य क्षपणेनोच्छ्रितस्य वा ।
कफस्थानानुपूर्व्या वा तुल्यकक्षाञ्जयेन्मलान् ॥ १४८ ॥
By causing the increase of any one of Dosha or by causing the decrease of that which is greatly increased or by treating Kaphasthana (seat of Kapha) first in the order of precedence, the Malas (Doshas) which are in equal standard, should be treated.

Sannipata Jvara Chikitsa: Treatment of fever caused by all three doshas

शमयेत्पित्तमेवादौ ज्वरेषु समवायिषु ।
दुर्निवारतरं तद्धि ज्वरार्तानां विशेषतः ॥ १४८+१ ॥
छर्दिमूर्छापिपासादीनविरोधाञ्ज्वरस्य तु ॥ १४८+२ ॥
सन्निपातज्वरस्यान्ते कर्णमूले सुदारुणः ।
शोफः सञ्जायते येन कश्चिदेव विमुच्यते ॥ १४९ ॥
रक्तावसेचनैः शीघ्रं सर्पिःपानैश्च तं जयेत् ।
प्रदेहैः कफपित्तघ्नैर्नावनैः कवलग्रहैः ॥ १५० ॥
At the terminal stage of Sannipata Jvara there develops a dreaded swelling at the root of the ear, from which only a few will be able to escape. It should be treated quickly by blood letting, drinking of medicated ghee, warm poultice with drugs which mitigate Kapha and Pitta, nasal medication and Kavala (mouth gargle).

Sannipata Jvara Chikitsa: Treatment of fever caused by all three doshas

शीतोष्णस्निग्धरूक्षाद्यैर्ज्वरो यस्य न शाम्यति ।
शाखानुसारी तस्याशु मुञ्चेद्बाह्वोः क्रमात्सिराम् ॥ १५१ ॥
Even after treatments which produce cold or heat, unctuousness or dryness, In whom the fever does not subside and when the fever travels to the Shakhas (become localised in the tissues) then the veins of his arm should be cut (to let out blood) quickly, as per procedure.

Vishama Jvara Chikitsa: Treatment of irregular fevers

अयमेव विधिः कार्यो विषमेऽपि यथायथम् ।
ज्वरे विभज्य वातादीन्यश्चानन्तरमुच्यते ॥ १५२ ॥
The same methods of treatment (described above) should be adopted even for VisamaJvara (remittent and intermittent fevers); by classifying (determining) the state of increase of Vata. The other treatment options described further should also be followed.

Vishama Jvara Chikitsa: Treatment of irregular fevers

पटोलकटुकामुस्ताप्राणदामधुकैः कृताः ।
त्रिचतुःपञ्चशः क्वाथा विषमज्वरनाशनाः ॥ १५३ ॥
Decoction prepared from three, four, or all the five of Trichosanthes dioica, Picrorhiza kurroa, Cyperus rotundus, Pranada – Terminalia chebula and Glycyrrhiza glabra cures VishamaJvara.

Visama Jvara Chikitsa: Treatment of irregular fevers

योजयेत्त्रिफलां पथ्यां गुडूचीं पिप्पलीं पृथक् ।
तैस्तैर्विधानैः सगुडं भल्लातकमथापि वा ॥ १५४ ॥
Fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis Terminalia chebula, Tinospora cordifolia, Piper longum each separately should be administered by their own suitable procedures; or Semecarpus anacardium along with jaggery (molasses) may be given.

Vishama Jvara Chikitsa: Treatment of irregular fevers

लङ्घनं बृंहणं वाऽऽदौ ज्वरागमनवासरे ।
प्रातः सतैलं लशुनं प्राग्भक्तं वा तथा घृतम् ॥ १५५ ॥
जीर्णं तद्वद्दधि पयस्तक्रं सर्पिश्च षट्पलम् ।
कल्याणकं पञ्चगव्यं तिक्ताख्यं वृषसाधितम् ॥ १५६ ॥
त्रिफलाकोलतर्कारीक्वाथे दध्ना शृतं घृतम् ।
तिल्वकत्वक्कृतावापं विषमज्वरजित्परम् ॥ १५७ ॥
On the day of onset of fever (VisamaJvara) either Langhana (fasting etc) or Brhmana (nourishing foods etc.) should be adopted first. In the morning or before food, Allium sativum together with oil or old ghee should be consumed, similarly it can be consumed either with curd, milk, buttermilk, or ghee separately, or Satpalaghrta (vide chapter 5 of Cikitsasthana), Kalyanaka Ghrta (vide chapter 6 of Uttarasthana), TiktataGhrta (chapter 19 of Cikitsasthana) and Vrsaghrta (chapter 2 of Cikitsasthana) may be consumed. Decoction of fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis Ziziphus mauritiana and Tarkari (Clerodendrum phlomidis), (four parts) equal quantity of curds, bark of Tilvaka (Symplocos racemosa), made into decoction all cooked to form a medicated ghee. This is best to cure VisamaJvara.

Vishama Jvara Chikitsa: Treatment of irregular fevers

सुरां तीक्ष्णं च यन्मद्यं शिखितित्तिरिदक्षजम् ।
मांसं मेद्योष्णवीर्यं च सहान्नेन प्रकामतः ॥ १५८ ॥
सेवित्वा तदहः स्वप्यादथवा पुनरुल्लिखेत् ।
सर्पिषो महतीं मात्रां पीत्वा वा चर्दयेत् पुनः ॥ १५९ ॥
Strong Sura and Madya (alcoholic drinks), meat of peacock, Tittari (black partridge) and cock, along with foods which are fatty and hot (in potency), should be consumed along with rice, as much as desired. After eating, the patient should sleep during the day or made to vomit once again, vomiting may be induced by giving him ghee in the maximum dose.

Vishama Jvara Chikitsa: Treatment of irregular fevers

नीलिनीमजगन्धां च त्रिवृतां कटुरोहिणीम् ।
पिबेज्ज्वरस्यागमने स्नेहस्वेदोपपादितः ॥ १६० ॥
Nilini (Indigofera tinctoria), Ajagandha (Cleome gynandra), Trivrt (Operculina turpethum) and Katurohini (Picrorhiza kurroa) should be consumed on the expected day of fever, after performing Snehana (oleation) and Svedana (sudation).

Vishama Jvara Chikitsa: Nasya and Anjana therapies

मनोह्वा सैन्धवं कृष्णा तैलेन नयनाञ्जनम् ।
योज्यं हिङ्गुसमा व्याघ्रीवसा नस्यं ससैन्धवम् ॥ १६१ ॥
पुराणसर्पिः सिंहस्य वसा तद्वत्ससैन्धवा ।
Realgar, rock salt, Piper longum are mixed in oil and made into a collyrium (eye salve) and applied to the eye. Ferula narthex muscle fat of a tigress equal in quantity, added with rock salt is administered as nasal drops; similarly old ghee along with musle-fat of a lion and Saindhava may be used as nasal drops.

Vishama Jvara Chikitsa using Dhoopa: Fumigation

पलङ्कषा निम्बपत्रं वचा कुष्ठं हरीतकी ॥ १६२ ॥
सर्षपाः सयवाः सर्पिर्धूपो विड्वा बिडालजा ।
Commiphora mukul, leaves of Azadirachta indica, Vacha (Acorus calamus), Saussurea lappa, Terminalia chebula, Brassica alba, Hordeum vulgare mixed with ghee should be used for fumigation; or it may be done with the excreta of cat.

Aparajita Dhupa

पुरध्यामवचासर्जनिम्बार्कागुरुदारुभिः ॥ १६३ ॥
धूपो ज्वरेषु सर्वेषु कार्योऽयमपराजितः ।
धूपनस्याञ्जनोत्त्रासा ये चोक्ताश्चित्तवैकृते ॥ १६४ ॥
दैवाश्रयं च भैषज्यं ज्वरान्सर्वान्व्यपोहति ।
विशेषाद्विषमान्प्रायस्ते ह्यागन्त्वनुबन्धजाः ॥ १६५ ॥
Commiphora mukul, Stylidium graminifolium, Acorus calamus, Vateria indica, Azadirachta indica, Calotropis gigantea, Aquilaria agallocha, Berberis aristata may be used for fumigation in all types of fevers. This is known as AparajitaDhupa. Recipes of fumigation, nasal medication, eye salves, and methods of sudden frightening psychological therapies, described in the (treatment of) disorders of the mind may also be adopted in Vishama Jvara. Daivashraya (providential) therapies cure all kinds of fevers, especially the VisamaJvara because these are usually produced by external factors.

Siravyadha: Venesection

यथास्वं च सिरां विध्येदशान्तौ विषमज्वरे ।
केवलानिलवीसर्पविस्फोटाभिहतज्वरे ॥ १६६ ॥
सर्पिःपानहिमालेपसेकमांसरसाशनम् ।
कुर्याद्यथास्वमुक्तं च रक्तमोक्षादि साधनम् ॥ १६७ ॥
If Vishama Jvara does not get cured, then the veins should be cut (to let out blood) as and how desired (for the aggravated Dosha). In fevers caused by Vata, alone, Visarpa (herpes), Visphota (small pox) and trauma, therapies such as drinking of medicated ghee, cold application (of paste of herbs), pouring decoction of herbs on the body, consuming food along with meat soup and bloodletting etc therapies should be adopted as suitable to the respective Dosha.

Agantu Jvara Chikitsa: Treatment of fever due to external agents

ग्रहोत्थे भूतविद्योक्तं बलिमन्त्रादि साधनम् ।
ओषधिगन्धजे पित्तशमनं विषजिद्विषे ॥ १६८ ॥
इष्टैरर्थैर्मनोज्ञैश्च यथादोषशमेन च ।
हिताहितविवेकैश्च ज्वरं क्रोधादिजं जयेत् ॥ १६९ ॥
क्रोधजो याति कामेन शान्तिं क्रोधेन कामजः ।
भयशोकोद्भवौ ताभ्यां भीशोकाभ्यां तथेतरौ ॥ १७० ॥
शापाथर्वणमन्त्रोत्थे विधिर्दैवव्यपाश्रयः ।
ते ज्वराः केवलाः पूर्वं व्याप्यन्तेऽनन्तरम्मलैः ॥ १७१ ॥
तस्माद्दोषानुसारेण तेष्वाहारादि कल्पयेत् ।
न हि ज्वरोऽनुबध्नाति मारुताद्यैर्विना कृतः ॥ १७२ ॥
ज्वरकालस्मृतिं चास्य हारिभिर्विषयैर्हरेत् ।
करुणार्द्रं मनः शुद्धं सर्वज्वरविनाशनम् ॥ १७३ ॥
For fevers caused by Graha (evil spirits, bacteria etc.) measures such as Bali (offering oblations), Mantra (incantation of hymns) etc., described in Bhuta Vidya (sorcery) are the methods of treatment. For fever caused by the smell of plants, therapies which mitigate Pitta, and for fevers caused by poison, antipoisonous therapies should be adopted. Fevers caused by anger etc. should be cured by providing things/conditions which satisfy the sense organs, pleasing to the mind, mitigating the aggravated Doshas and by explaining the suitability and unsuitability of things (desired by the patient). Fever caused by anger gets relieved by fulfilling the desires, and that caused by desires gets relieved by anger; those born out of fear and grief get relieved by them (desire and anger in reverse order) and fevers due to others get relieved by fear and grief. For fevers, caused by curse (of gods, ascetics etc.) and hymns of Atharvana (sorcery, witch craft etc.), DaivaVyapasraya – divine rituals are the treatment. These fevers initially spread out just by themselves (not connected to anything) and later (after getting associated with doshas) get spread by Doshas. Therefore in these conditions, diet etc should be planned according to the involved doshas no fever occurs without the association of the vata etc. doshas Memories of the time of commencement of the fever should be vanquished by things pleasant to the mind (the patient should be made to forget the time of commencement of fever by diverting his attention). Compassionate and pure (non-emotional, calm) mind cures all types of fevers.

Apathya: Unsuitable things in fever

त्यजेदाबललाभाच्च व्यायामस्नानमैथुनम् ।
गुर्वसात्म्यविदाह्यन्नं यच्चान्यज्ज्वरकारणम् ॥ १७४ ॥
Till the gaining of strength, fever patient should avoid physical exercise, bath, sexual intercourse, foods which are heavy (not easily digestable), unaccustomed and which cause heartburn and all other caustative factors that produce fevers.

Apathya: Unsuitable things in fever

न विज्वरोऽपि सहसा सर्वान्नीनो भवेत् तथा ।
निवृत्तोऽपि ज्वरः शीघ्रं व्यापादयति दुर्बलम् ॥ १७५ ॥
Though relieved of fever, he should not begin to eat suddenly all types of food,

ज्वरः निवृत्तो अपि व्यापादयति दुर्बलम् शीघ्रं – jvaraḥ nivṛtto api vyāpādayati śīghraṃ durbalam – for fever, though relieved, kills the weak patient soon.

Apathya: Unsuitable things in fever

सद्यः प्राणहरो यस्मात्तस्मात्तस्य विशेषतः ।
तस्यां तस्यामवस्थायां तत्तत्कुर्याद्भिषग्जितम् ॥ १७६ ॥
Since the fever takes away life quickly it should be addressed with priority (amongst all diseases), it should be treated at each stage, beginning from Ama stage, suitably.

Pathya: Suitable things in fever

ओषधयो मणयश्च सुमन्त्राः साधुगुरुद्विजदैवतपूजाः ।
प्रीतिकरा मनसो विषयाश्च घ्नन्त्यपि विष्णुकृतं ज्वरमुग्रम् ॥ १७७ ॥
Wearing of potent herbs and precious gems, chanting benevolent hymns, worship of saints, preceptors, the twice born (Brahmans) and Gods, Affectionate mind and (indulgence in) objects, pleasing the mind cure dreadful fevers though caused even by God Vishnu.

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने ज्वरचिकित्सितं नाम प्रथमोऽध्याय: ॥१॥
Thus ends the chapter JvaraChikitsita – the first in Chikitsitasthana of Astanga Hrdaya Samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.